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Medical Insurance (Deductible and out of pocket)?

Okay. I recently had my hand surgery and it costed me $7000. I have blue Cross Insurance and my deductible is $5000 and my out of pocket is $4000 and my coinsurance is 80/20. So I pay 5000 first because it is a requirement, and do i pay my 20% coinsurance of 7000(surgery cost)? or 7000-5000=2000 20% of 2000? Next if i do pay the detuctible and coinsruance, what is out of pocket mean?

Public Comments

1. The $2000 of coinsurance will come out of your "out of pocket" so were you to have another surgery, you would "only" be on the hook for $2000. Is the $7000 the bill from the hospital? Because the insurance will likely have negotiated a much lower rate. You could easily end up paying only $3500.
2. Out of pocket should be the total you pay in coinsurance--like a cap. So you pay $5000, then you pay $20 UP TO $4000, then the insurance pays 100% for the rest of the year. The 20% would be of the $2000 leftover after they took out your deductible (so they take out your deductible and then split what is left between your 20% and their 80%).
3. your deductible is what you pay first then your co insurance kicks in ... up to your out of pocket max so if your deductible is $ 5000 ... you pay that ... then 20% up $ 9000 then it should be 100% for all covered benefits for the calendar year. (ask if your out of pocket max (4000) includes your deductible (5000)) meaning your out of pocket is 9000$